A morning out and about

Yesterday we went to get our NIE numbers, this entailed a visit to a police station with a department of foreigners. The nearest one is about 40kms away so it was handy I didn’t have to go to the health centre, as I have to do this late morning and it would have been uncertain if we would get there with enough time to get things sorted.

So we had an ‘early’ start (which is later than it was as I seem to spend a lot of time not being able to find things). I’d like to say this was ankle related – but it’s not. Strangely in the two minutes before shutting the front door my mind goes to jelly – I can’t find shoes, keys, bags…. and find myself assuring Ian that I am ready whilst patently being in a complete state of chaos.

It was a pleasant drive and we headed north through the red soiled fields which alternated olives and grapes. Everything is very golden now – but the soil is a rich red. The grapes were being picked and a couple of times we got stuck behind a tractor with a trailer oozing freshly picked grapes.

Needless to say when we got to the town we got lost, and took a couple of turns around before we found the police station. It was tucked in a small plaza in the shade of trees nestled under the large central church. Ian dropped me off outside and I lurked around waiting for him to park and he went to find where we should be going.

Up a flight of steep marble stairs and no lift!

I ignored Ian’s offer of a firemans lift up the stairs – gave up any thoughts of applying for my card in person – although I could wave if someone cared to stick their head out the window, and I headed over to a bench under the trees outside whilst ian had to run around doing the things we had forgotten – ie copies of passports, pens etc.

Under most trees in the villages towards midday, groups of elderly men will gather to pass the time of day and putting the world to rights – or simply watching the world go by. True to form after a few minutes I had new friends and in between the contented silences, they would exchange the odd word. Eventually they drew me into the conversation and told me that when I was off the crutches I must get a stick like ‘this’ and a rather splendid wooden stick was waved at me. But, I must understand that I will not get one so good as it was handmade by the best stick maker of this town. One by one they wandered off – to another tree or perhaps to a bar and Ian reappeared and we filled in our forms and he disappeared again.

I was looking forward to another few moments contemplation – enjoying the dappled sun in the shade of the imposing church - a rare treat of doing nothing legitimately, however this time I was jolted awake by a lot of arm waving and gesticulation which was getting louder and more passionate. I know through experience that arguments sound a lot worse in another language – and the content of this was probably ‘you forgot to pack the sandwiches…?’ However ‘time to hop on’ I thought and I hopped round the corner to wait for Ian. The whole thing took less than an hour, and if we had with us everything we needed to it would have taken a lot less.

When we got home my foot was aching. Not through any form of activity, but because I think it was feeling the vibrations of the car, also I guess because it was a long time without my foot up?

4 Weeks on...

4 weeks today since I broke my ankle. Amazing! To think that I went to bed that night fully expecting to get up as normal the next day and one fall and four weeks later here I am still trying to get used to life on one leg. Had I known what to expect I would have made more plans – not least making sure I had adequate suppliers – poor Ian is going to have to stock up on toiletries and other bits and pieces soon.

Of course now I am looking at things with the benefit of hindsight, and there are a few things I could have done (well actually asked Ian to do) which would have helped. One thing would be to sort out somewhere low to keep clothes. I hate to having to ask Ian to help and I really don’t want to feel that I am taking advantage or being an imposition. So when he kindly takes my washing off the washing line and putting it on the bed, I can only move it to on top of the basket box, where if I don’t keep the room cat free, it falls onto the floor and becomes a cat nest. If I was planning for this I would have cleared a couple of drawers in a chest of drawers at sitting height and ensuring that there is a chair in front. As I have found that I am spending most of my time in t-shirts and shorts because of the heat, I am not having to worry about finding clothes that are cast friendly. Hopefully by the time the weather changes my ankle whilst still perhaps in a cast will be a lot less sensitive to being jolted as I hop around putting clothes on.

I'm getting quite good now at communicating what happened with my leg, and most people now know anyway. People always take the time out to ask me how I am, or if Ian is out on his own they ask after me - the warmth and kindness has been wonderful. I am even able to crack a joke in Spanish which is that I am good for a person hopping on one leg. Ok - it's a bit of a pathetic joke, but a few months ago I could get as far as asking for a beer and that entailed a certain amount of headscratching! My lack of Spanish was how I got into my last foot related scrape which was when I ended up taking part in a 24 km walk by mistake (I heard 2 km), and my toe nails fell off in shock.

I had my dressing changed today and there was some bleeding on the left hand side, but not much really. I don't have to go back until Friday to get it changed which is great. Whilst it can be quite quick if we get there at the right time, today we timed it perfectly wrong and had to wait for quite a while before we saw the nurse. This also means we can get to the Police Station to register for our NIE numbers.



PS: This pic was taken outside the healthcentre - a man taking his lamb and dog for a walk.

Love is.....

Washing the toes on your beloveds plastercast foot. Ian today – with only minimal amount of pleading on my behalf helped me wash the toes of my cast foot. After he fell over in a dead faint, he assured me that the region of my cast was reasonably whiff free. However, it is amazing how long he can hold his breath for.

I tried a new shower technique today. Up until now I have sat on the side of the bath and lent backwards to shower and wash my hair – it has been reasonably successful, but a bit perilous. I have also tried a bath – but this was quite labour intensive and not quite the luxurious bathtime experience that I would normally enjoy. Today’s experiment was trying to shower in two halves, left first and then right. However this unfortunately ended in me ‘setting’ into position in the bath and requiring rescuing.

I have backache today, I think it is partly to do with sitting with my leg up as it means I sort of ‘slump’ in the chair. I need more propping up with pillows, but this is all difficult to achieve – hopping on crutches with a couple of pillows is not easy! I do wish I could find more information about exercises etc, I do feel there is more that I could be doing to help myself. I am also conscious that lack of exercise is also likely to result in putting on weight. I’d prefer not to give myself even more weight to drag around on the crutches – it’s hard enough as it is!

We might go out tonight for a quick drink - I've said before about the problems of getting out, but that has really been about my lack of ability to get very far under my own steam. Another quite big issue about going out for an evening for me is getting on and off the toilet in a bar (sorry to be so basic) where they are unlikely to have a strategically placed chair in front to help with getting up and down, and I have a fear of getting stuck or falling over - or even worse pulling the sink off the wall which I use as leverage - a move unlikley to endear me to the bar owners! Most of the bars entail quite a big hop either in or out, and I worry about getting my aim wrong and making the wrong sort of entrance - so all in all it is easier to stay at home. I've never really thought about disabled access before - or at least I have, but not from a users perspective. I would definately be better placed in the uk with the access requirements meaning that buildings are accessable to all, in Spain it is a requirement in new public buildings, but not I believe in existing ones. As I had to navigate the two steep marble steps into the orthepedic shop I did muse as to when similar require would filter their way through to the remote rural areas like Extremadura. Hence the possibility, at the moment, of finding a bar with disabled access locally is almost zero.

Last of the staples

Hooray, all the staples are out. I am not sure how many I had, a few have come out every day with the last ones on Friday. Friday night my foot was very painful – I went to bed at 10 and kept my foot propped up on a few pillows. I slept fitfully. When I came home from hospital I didn't sleep well at all - I was terrified of getting out of bed and forgetting about my leg and doing more damage - or worse having pins and needles in my other leg and breaking that one too. I tried many different things - including having the crutches so close to the bed that they were the first thing I saw when I awoke - however this just meant that they kept falling onto my head. Constantly being banged on the head by falling crutches was hardly condusive to getting a good night sleep. Slowly however proper sleep came back - very much so, and i'd been getting a clear 8 or 9 hours a night which must be doing me good.

The pain is from the surgery wounds not from the bone. Hopping on the crutches causes a jolt which was very painful. I developed a strange bouncy hop which cushioned some of the jolt – but I was glad this morning when the pain reduced. However is still quite painful. Hope it is not bleeding. I don't think the heat is helping as it makes everything a little sticky and unpleasent.

I have stopped crying at the healthcentre - which is good. I think that I kept welling up as I found the wounds quite shocking. Although I had seen them and of course knew that they were there, I'd not really 'looked' at them if you know what I mean, and therefore being confronted with them seemed to bring it all home.

I’ve been looking at other forms of cast – for instance the Aircast walker. I like the idea of the variable support – and the fact that the cast can be removed enabling exercise (and washing - how nice!), however at over £140, I would need to be assured that this would be money well spent. see here It seems to be a high tech plastic cast, which I guess would be ideal at the moment when the dressing is being changed daily. However probably best to stick with what I have been given.

A wheelchair would be nice....

We've put posters up around the village asking for a wheelchair. The crutches are hardwork and it means that I really can't do very much. It also means I am pretty pathetic around the house, I cannot even carry a drink outside and simple tasks seem to turn into a bit of a palaver. I have tried carrying a shoulder bag with me and filling a water bottle up, and putting things I want in the bag, but I am inclined to drop my crutches at the sink, or drop the bag etc, which mean that I am more annoying than normal.

A wheelchair would mean I could help with housework too :( . We have been to the shop by the hospital who have some but they are all over 350 euros, which is out of our reach at the moment - and there is nothing on Ebay.es. Ebay.co.uk have a few but postage to Spain put them again out of our reach. You'd have thought someone somewhere might have one tucked away which they would lend me. One nasty thought - the poster was written by us in our own special form of Spanish (ie bad) - I hope that I haven't mistakenly asked for a wheeled prawn or something which equally random which might explain why we have not had any response.

People say the crutches will get easier - I hope so. At the moment I am pretty much house bound, whilst we can get out in the car, I am pretty limited at what else we can do - I can get from car to bar (hooray), but don't like to stay too long or have more than the odd drink as I worry about falling over again. I am ruing the cobbled roads - this also makes going out on crutches a tad haphazard. It also means that I am totally dependent on Ian to take me anywhere - even to get a loaf of bread.

I've been listening to Moonstone on bbc radio 7. It has been excellent - other than the fact I got confused with Moonfleet and spent the first two episodes wondering where the smugglers were. http://www.bbc.co.uk/bbc7/index.shtml?logo

Some staples come out and I didn't cry

Today was the locum again at the healthcentre and we got prescriptions for new pain killers and anti-coagulants. She took a good look at the wounds and prodded a bit - but it was no where near as painful as before. I am not sure what the prodding is for - probably to see how the would is healing. My concerns over how they actually took the staples out were unfounded, and the actual removal of the staples was painless. I think I was remembering taking staples out of furniture when upholstering, which entails prising with screwdrivers and quite a lot of force. I guess if I thought about it I would realise that as hundreds of thousands of people have wounds held to gether all the time with staples it was hardly likely to be a painful and traumatic (and that is just for the nurse!) process to remove them. The staples have been a bit sore against the edge of the cast, so I think that some of this irritation will stop when the staples are all out.

I welled up a bit, but didn't blub. I think everyone was pleased about this!

How big?

I haven't really looked at the wounds, I can see that my foot is still puffed, however I can live quite happily without seeing the staples in the wounds either side of my ankle. I know they are there and that was all I needed for a while.

However I thought I'd have a good look today and I must admit to being a little surprised. The wound on the left side of my ankle is about 4 inches long and the one on the right about 6 inches? That explains why I have had pain further up my leg on the right hand side. Shame as my ankles were one of my better features...

I have had a quick look on the internet for recovery hints and tips. I was encouraged to note it may be several months before I am able to play sport again at a professional level. Quite frankly as one of lifes least sporty people I would regard that as a miracle!

I note I need to be wiggling my toes which I do, and I have been trying to do some regular leg-waving excercises so my right leg doesn't get to weak - however already I can feel a difference in my legs - with another few weeks before I can put weight on my leg I wonder how weak my right leg will end up. I think I ought to find a physio.

Healthcentres

Ian has been injecting me with the anti-coagulants - you can imagine the scanario although he does have an advantage as I can't run away. As he was away on Monday I was going to go to the health centre. I must admit that I had a rather strange idea of how far I would be able to go on crutches, thinking I'd be hopping round the village in no time. The baker is about as far as I can get - which is only a couple of doors down and this entails resting on the way back. It was impossible to get to the health centre when Ian was away so I gave Emma, who was kindly staying with me for a week to help me when Ian was away, with a note and asked her to see Tony and Montse in their bar and see if they could ask for a nurse (any nurse) to come round. Tony has a bad back and is also going to the nurse regulary so he was going to ask when he went to the health centre. However a nurse didn't turn up which left us all a bit high and dry.

Tuesday was a Spanish holiday and Tony came round to get me and we went to the emergency clinic in Llerena to be injected. Me with the anticoagulants and him with his painkiller. We must have looked a right pair and we got injected at the same time, so we were stood there me exposing my stomach which now looks like a pin cushion and him his back. We buy our drugs from the famacia and keep them here, so I was amused by us sat in the waiting room with our hyperdermics clutched tightly...

Ian was supposed to be working away for a few months - however we have decided given the difficulties of only a couple of days and that is with Emma staying that it would be too difficult for me on my own - so sadly (or perhaps not...?) the saga of the broken ankle is having longer reaching effects.

The normal village doctor is away and I had my first visit with the locum doctor, I had written out some questions however he refered me to the hospital, where we met another of our neighbours who sent me to the health centre.

The first day at the next town health centre was ok - but the second day was horrible. Ian thought I was going to hit the doctor with a crutch. The person I saw at the healthcentre read my 'enforma', was muttering and shaking his head about my ankle and then as if to double check started prodding it so roughly that I screamed and clutched a crutch. Apparently neither the two 4 inch scars, nor the fact that the fracture is classified as severe did not suggest the pain that I might be in! He was also prodding around the staples at which point I was going to either faint or leave, but he was actually seeing if they were ready to come out. I am hopefully going to have half out next week - but what half.... If it is the same man then I am definately leaving, I can imagine him coming towards me with a staple remover, or screw driver to prise them out.

I've run out of anti coagulants which we will have to get tomorrow. I have to take these for another few weeks. Ian is very gentle and quick, but my whole middle is feeling very sore. He keeps telling me that these are a lot smaller needles than he used to inject the goats. I did point out that goat skin is likely to be a bit tougher than me. Well hopefully.

The web and broken ankles

One of the things I was looking forward to on my return from hospital was the wealth of information I was going to find on the internet to help me understand more about what had happened and how the recovery was going to develop. Afterall, if there are zillions of blogs about knitting there are bound to be one or two about people experience of broken ankles.....?

Wrong!

So far I have found information on the web sadly lacking - and I didn't think I'd ever find myself saying that. I suppose the good thing is that I am still in a position of naive bliss not knowing what is coming next - but on the other hand I'd quite like to prepare myself. I can exchange a few words with the nurse ie me: - 'bien...?' Nurse 'si'. However at times it would be good to go into a little more depth. Mind you the only stuff I have found on the web suggests that I might have to have the plates taken out when I get older. And go through all this again - oh joy! Perhaps I am better not to know.

How difficult are crutches?

Bloomin’ difficult let me tell you! All that feeding up in hospital has also given me a few extra pounds to carry around with me – great.

The plans now I am home are for regular visits to the health centre here in the village. This means the indignity of rolling around in the back of the transit as I cannot get into the front cab. I am unceremoniously dumped outside the health centre, where I hop pathetically with the crutches into the waiting room, where people move out of the way for me – probably thinking I am about to collapse, which quite frankly after a few yards on the crutches is a feeling I often have!

We have to go and buy our injections, so Ian was sent off up to the chemist and the local nurse will inject me when I go there at mid day. I hate that injection. My stomach is like a pin cushion!

It was great coming home, all the dogs were excited - including Bob who was desperate to get into the bedroom. We let him in and in he bounded, quick sniff for his Baby, then out he dashed without even a glance in my direction. Hmmmm.

I’ve been researching diets – I am quite a believer in diet supporting health and hope that by increasing my calcium consumption I might hasten the mending of the bones. I nearly combined fainting with collapsing in hysteria when I read this on a website that came top of a Google search. It said that people suffering from broken bones should be 'bled'. Luckily before I suffered any long term mental damage and pathelogical fear of the medical profession I checked the website and I think that 'american revolution' probably explained all.....

Some background

I would like to say that I broke my ankle doing something rather exciting or brave, but the sad fact is I just fell over.

On the night of 31st July, getting out of bed to turn the light out I had a severe case of pins and needles which meant that as I got out of bed to walk across the room, I had no feeling in my legs and immediately fell. I knew that I had ‘done something’, but I had no idea what. I thought perhaps a sprained ankle, I could move my toes so (thinking back to my girlguide training) assumed that nothing was broken. Ian was quick off the mark (once my shouts were heard over his trumpeting snores, and he eventually woke) and we managed to get me onto the bed, with ankle wrapped in frozen chickpeas. This was the beginning of many indignities.

For too many long and boring reasons to go into, Ian was due to be dropping a hire car off in Seville the next morning which meant leaving the house at 6.30. We weren’t unduly worried as we both believed that the ankle would be better in a couple of hours. However it wasn’t and whilst laying in a pool of melting chickpeas I was laying there wondering about the first problem – how was I going to get to the loo. A little while later this problem became a bit more urgent – so again I needed to wake up the slumbering nose-trumpeter next to me and we were wheeling me through the house on a armchair and then trying to lower me onto the loo without falling over or doing further damage. I think I realised then that this probably was not a sprain and that I was looking at something more significant.

Hence at 6.45 I was sat in the Urgencia section of Llerena Hospital awaiting to see a doctor and to try and communicate what had happened with a mix of mime and o’level Spanish. Luckily the swelling gave them a bit of a clue, and my shout of panic when they grabbed the ankle indicated the sort of pain I was in.

By 9.00 I had been x-rayed and was sat on a trolley waiting for further information. My key concern at this point was how I was going to get home when Ian was not going to be back from Seville until much later. So it was with surprise when a doctor came and told me I would have to stay in hospital for 24 hours. My lack of Spanish and his lack of English meant that my questions as to why I needed to stay in hospital needed some additional support – so another doctor was drafted in to tell me that I had broken both bones in my ankle, that the break was severe and I would have to have an operation to fit plates. This was a complete shock and I hoped that something had got lost in translation – however as they came for my clothes (thankgoodness I was wearing my birthday pants) and started measuring my heart, x-raying my chest and fitting drips that it fully hit me that I was not going to be home for a few days. It was also a surprise as the x-ray seemed to show 3 broken bones - surely that can't be right....?

In between the above I managed to make a call to Ian to tell him what was happening and he had to negotiate the spanish coach and bus system to get back from Seville and some and see what was happening.

Tuesday was a difficult day, I was very much in the system by then, and seeing surgeons and doctors, getting medication and trying to think positive thoughts. I was also getting used to hopping with the support of a Zimmerframe type contraption and trying to do my ablutions on one leg. I was also finding out about the joys of the Spanish hospital food – feed the patients up seemed to be the moto – and I was facing huge meals 4 times a day. I was even woken up to have the final meal of milk and biscuits in the evening!

Wednesday the nursing staff was trying to communicate the plans for the next day which was surgery day. The surgeon told me I had an unlucky ankle and that whilst the operation was difficult it was routine. The nursing staff kept coming into to brief me with different bits and pieces. I didn’t fully understand what was going on, so we rang one of our spanish speaking friends to speak to the doctor and to translate what was happening. It was quite simple and not as complex as we thought – it was simply a case of the fact I had to be ready first thing in the morning in case they were running ahead of time, and I had strict instructions of what I was supposed to be doing in the morning in term of washing etc.

I had a sleeping pill on the Wednesday so had a good night sleep and then on Thursday Ian came in at 8, we washed me down in some form of super antiseptic and then I had a special gown and I sat on the bed in a cool and calm manner. Well it is all true but the last bit – I got into a bit of a panic and a kindly nurse gave me some form of tranquiliser to calm me down. This worked and the rest of the day desolved into some fuzzy hazy mist.

I had a epidural which meant I was still vaguely with it. I can remember the operation – and the sensation of the ankle being cut. Is that normal? It didn’t hurt but it wasn’t nice. I could also see a screen with an x-ray of the plates going in – and hear the noises – again unpleasant, so I hummed over the top of it, something which would have been equally unpleasant for the surgery staff.

I was pleased to see Ian after the op – in all it came to about 90 mins before I was back in the recovery room, and as the feeling started to come back in my legs so I was able to wiggle around a bit and make sure that everything felt right. It did - and all I was aware of on my ankle was a bulky cast.

The rest of Thursday was a blur and on Friday I saw the surgeon who said he was pleased with how things went. One tricky moment in hospital after the op. The Spanish word for toes is the same as fingers - dado. The surgeon obviously knew the one translation which was 'fingers'. So he was there studying my toes, but asking me to move my fingers. I was laid down so couldn't see where he was focussed and I was busy wiggling my fingers as requested. The surgeon got increasingly disturbed as he was telling me to move my fingers, I was saying that I was, but he could see no movement in my toes which he was studying. Just as he was convinced that I had lost the feeling and movement in my foot he realised what the 'problem' was and promptly disolved into tears of laughter. After that - along with all the other indignities suffered, I also had to suffer the surgeons flexing their fingers and collapsing in laughter when they came into see me!

I was very touched by the number of people from the village who came into see me - I was also amazed at the number of people from the village who work there. Every day people would pop into say hello - which was great, and as they would drop in often before or after shifts then it meant that people were visiting from early to late in the evening. Unfortunately my limited vocabuary meant that conversations were fairly brief - however I did find I learnt a lot of new spanish words, which is always useful!

I asked to be discharged on Sunday – however they said they needed me to see the doctor on Monday so Sunday was spent with a heavy heart. The hospital was fine – but it is quite lonely being somewhere where you don’t know any one – or speak the language, I found the nights incredibly long, but that did mean I dozed a lot during the day.

Monday was discharge day. Hooray. We had to buy our own crutches, so Ian went over the road to the orthepedic supply shop and bought a pair. It would have been helpful if I had given them a bit of practice before having to negotiate the way out of the hospital - but hey, I was nearly home.

The trip home entailed rolling around in the back of the transit and being dumped outside the front door whilst Ian took it round the back (rather than block the road whilst I spent ages working out how to get over the front door setp. I was delighted to get home into my own environment.